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1.
J Infect ; 79(5): 435-443, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31419474

RESUMEN

An outbreak of an uncommon emm type (emm66.0) of group A streptococcus (GAS) occurred in England and Wales between January 2016 and May 2017, involving 52 individuals who were homeless or injecting drugs users. In order to investigate the outbreak, epidemiological and network analysis were performed; moreover 55 isolates (32 outbreak, 5 non-outbreak and 13 historical - 2005-2015) were tested with whole genome sequencing (WGS), antimicrobial resistance determination, Bayesian evolutionary analysis (BEAST). Forty one isolates (including 32 outbreak strains) belonged to a single emm66.0 clade (average SNP difference 6.6; range 0-16 SNPs) separate from the other isolates and two strains previously considered part of the outbreak (SNP average: 5876; range 93-8417 SNPs). Antibiotic resistance was not detected in the outbreak clone. No common source of infection was identified. WGS confirmed expansion of an emm66.0 clone in a hard-to-reach population and enabled refinement of the initial case definition.

2.
Rev Esc Enferm USP ; 53: e03457, 2019 May 30.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31166537

RESUMEN

OBJECTIVE: To analyze hypertension and its relationship with the causes of death identified by the autopsy. METHOD: Cross-sectional study analyzed 356 participants belonging to the Brazilian Aging Brain Study Group, over 50 years of age, autopsied at the Sao Paulo Autopsy Service between 2004 to 2014. A clinical interview was conducted with the informant of the deceased. Hypertension was defined by reporting the disease and/or use of antihypertensive medication, by the informant of the deceased. Descriptive analyzes and bivariate and multivariable associations were performed. RESULTS: The prevalence of hypertension was 66.2% and it was the second leading cause of death (25.6%) identified by autopsy, preceded by atherosclerosis (37.8%). The variables associated with hypertension were: female gender (OR=2.30 (1.34-3.90)); living with partner [OR=0.55 (0.32-0.92)]; Body Mass Index [OR=1.14 (1.08-1.22)] and history of diabetes [OR=2.39 (1.34-4.27)]. CONCLUSION: The prevalence of hypertension was high, and it was the second most common underlying cause of death. The gold standard for the definition of cause of death, the autopsy, shows important results, which confirmed the relevance of hypertension as a public health problem.


Asunto(s)
Aterosclerosis/epidemiología , Causas de Muerte , Hipertensión/epidemiología , Anciano , Anciano de 80 o más Años , Antihipertensivos/administración & dosificación , Autopsia , Brasil/epidemiología , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales
3.
Nutr Hosp ; 36(1): 125-132, 2019 Mar 07.
Artículo en Español | MEDLINE | ID: mdl-30834771

RESUMEN

Introduction: Introduction: one of the changes in diet is related to its content of sodium (Na) and potassium (K). Greater use of condiments and processed foods contributes to these changes and the Na/K ratio can be used as a marker of this consumption. Objective: to evaluate the association between Na/K ratio and consumption of industrialized condiments and ultra-processed foods. Methods: a sample of 150 adults underwent an anthropometric examination and answered the questionnaire on life habits, diet and health. Consumption of Na, K and salt was estimated by urinary excretion of 24 hours. Ultraprocessed consumption was estimated by 24-hour food registration. Na/K ratio divided into tertiles. Associations between ultraprocessed foods, use of industrialized condiments and Na/K ratio were tested. p < 0.05 was adopted. Results: the highest proportion was female (65%) and with a higher educational level (77%). Higher consumption of ultra-processed foods was observed in men, in those with higher schooling and in non-whites. Those who reported a frequent consumption of industrialized condiments showed a mean sodium of 4.1 ± 1.4 g/day (p = 0.03) and salt of 10.5 ± 3.6 g/day (p = 0.03). Among those who reported frequent use of industrialized condiments, a higher Na/K ratio was found and a lower ratio was observed among those with lower consumption of ultraprocessed foods. Hypertensive and those with salt intake above the recommended one presented higher Na/K ratio. Conclusion: frequent consumption of industrialized condiments is associated with higher salt excretion and Na/K ratio and higher consumption of ultraprocessed products increases Na/K ratio.


Asunto(s)
Condimentos , Alimentos , Potasio/orina , Sodio/orina , Adulto , Anciano , Escolaridad , Conducta Alimentaria , Femenino , Manipulación de Alimentos , Humanos , Hipertensión/epidemiología , Hipertensión/orina , Estilo de Vida , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos , Sodio en la Dieta , Encuestas y Cuestionarios
4.
Acta fisiátrica ; 26(1)mar. 2019.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1046642

RESUMEN

Objetivo: Descrever o processo de desenvolvimento e validação do instrumento baseado no Core Set resumido da Classificação Internacional da Funcionalidade, Incapacidade e Saúde para indivíduos com lesão medular aguda. Método: No estudo metodológico foi desenvolvido um instrumento para avaliação da funcionalidade de indivíduos com lesão medular aguda traumática. A validação de face e conteúdo do instrumento foi realizada por um comitê de especialistas, compreendendo as etapas preconizadas na literatura. Como parte desse processo, foi realizado o pré-teste, com 10 indivíduos com lesão medular aguda traumática, com até 6 meses de lesão. Resultados: Na maioria dos itens do instrumento, os participantes fizeram sugestões que visavam à modificação de termos técnicos, para serem substituídos ou reformulados para melhor compreensão pelo público alvo. Para a análise de dados o mínimo de concordância estabelecido foi de 80%. Conclusão: A contribuição do estudo refere-se à possibilidade de utilizar uma ferramenta inovadora pela equipe multidisciplinar na prática clínica.


The research aimed to describe the instrument development and validation process based on the brief Core Set of the International Classification of Functioning, Disability and Health for individuals with Acute Spinal Cord Injury. In the methodological study, an instrument was developed to evaluate the functionality of individuals with acute traumatic spinal cord injury. The face and content validation of the instrument was performed by an expert committee, understanding the steps recommended in the literature. As part of this process, a pretest was performed with 10 individuals with acute traumatic spinal cord injury with up to 6 months of injury. In the results, in most items of the instrument, participants made suggestions to modify technical terms, to be replaced or reformulated for better understanding by the target audience. For data analysis the minimum agreement established was 80%. In conclusion, the contribution of the study refers to the possibility of using an innovative tool by the multidisciplinary team in clinical practice.


Asunto(s)
Humanos , Traumatismos de la Médula Espinal/rehabilitación , Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud , Estudio de Validación
5.
Nutr. hosp ; 36(1): 125-132, ene.-feb. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-183198

RESUMEN

Introducción: uno de los cambios en la alimentación está relacionado con su contenido en sodio (Na) y potasio (K). El mayor uso de condimentos y alimentos industrializados contribuye a estos cambios y la relación Na/K puede ser utilizada como marcador de ese consumo. Objetivo: evaluar la asociación entre la relación Na/K y el consumo de condimentos industrializados y ultraprocesados. Métodos: la muestra estuvo compuesta por 150 adultos que fueron sometidos a examen antropométrico y respondieron al cuestionario sobre hábitos de vida, alimentación y salud. El consumo de Na, K y sal fue estimado por excreción urinaria de 24 horas y el consumo de ultraprocesados, por registro alimentario de 24 horas. La relación Na/K fue categorizada en terciles. Se probaron asociaciones entre alimentos ultraprocesados, uso de condimentos industrializados y relación Na/K. Se adoptó una p < 0,05. Resultados: la mayoría de los participantes era de sexo femenino (65%) y con alta escolaridad (77%). Se observó un mayor consumo de ultraprocesados entre los hombres, especialmente en los de mayor escolaridad y no blancos. Los individuos que relataron consumo frecuente de condimentos industrializados presentaron un mayor consumo de sodio (4,1 ± 1,4 g/día, p = 0,03) y sal (10,5 ± 3,6 g/día; p = 0, 03). Entre los que relataron uso frecuente de condimentos industrializados se encontró mayor relación Na/K y esta relación fue menor entre los de menor consumo de alimentos ultraprocesados. Los hipertensos y los participantes con un consumo de sal por encima de lo recomendado presentaron mayor relación Na/K. Conclusión: el consumo frecuente de condimentos industrializados está asociado a mayor excreción de sal y relación Na/K, así como el mayor consumo de ultraprocesados aumenta la relación Na/K


Introduction: one of the changes in diet is related to its content of sodium (Na) and potassium (K). Greater use of condiments and processed foods contributes to these changes and the Na/K ratio can be used as a marker of this consumption. Objective: to evaluate the association between Na/K ratio and consumption of industrialized condiments and ultra-processed foods. Methods: a sample of 150 adults underwent an anthropometric examination and answered the questionnaire on life habits, diet and health. Consumption of Na, K and salt was estimated by urinary excretion of 24 hours. Ultraprocessed consumption was estimated by 24-hour food registration. Na/K ratio divided into tertiles. Associations between ultraprocessed foods, use of industrialized condiments and Na/K ratio were tested. p < 0.05 was adopted. Results: the highest proportion was female (65%) and with a higher educational level (77%). Higher consumption of ultra-processed foods was observed in men, in those with higher schooling and in non-whites. Those who reported a frequent consumption of industrialized condiments showed a mean sodium of 4.1 ± 1.4 g/day (p = 0.03) and salt of 10.5 ± 3.6 g/day (p = 0.03). Among those who reported frequent use of industrialized condiments, a higher Na/K ratio was found and a lower ratio was observed among those with lower consumption of ultraprocessed foods. Hypertensive and those with salt intake above the recommended one presented higher Na/K ratio. Conclusion: frequent consumption of industrialized condiments is associated with higher salt excretion and Na/K ratio and higher consumption of ultraprocessed products increases Na/K ratio


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Condimentos , Alimentos , Hipertensión/orina , Potasio/orina , Sodio/orina , Escolaridad , Conducta Alimentaria , Manipulación de Alimentos , Hipertensión/epidemiología , Estilo de Vida , Factores Sexuales , Factores Socioeconómicos , Sodio en la Dieta , Encuestas y Cuestionarios
6.
Rev. Esc. Enferm. USP ; 53: e03457, 2019. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1003107

RESUMEN

ABSTRACT Objective: To analyze hypertension and its relationship with the causes of death identified by the autopsy. Method: Cross-sectional study analyzed 356 participants belonging to the Brazilian Aging Brain Study Group, over 50 years of age, autopsied at the Sao Paulo Autopsy Service between 2004 to 2014. A clinical interview was conducted with the informant of the deceased. Hypertension was defined by reporting the disease and/or use of antihypertensive medication, by the informant of the deceased. Descriptive analyzes and bivariate and multivariable associations were performed. Results: The prevalence of hypertension was 66.2% and it was the second leading cause of death (25.6%) identified by autopsy, preceded by atherosclerosis (37.8%). The variables associated with hypertension were: female gender (OR=2.30 (1.34-3.90)); living with partner [OR=0.55 (0.32-0.92)]; Body Mass Index [OR=1.14 (1.08-1.22)] and history of diabetes [OR=2.39 (1.34-4.27)]. Conclusion: The prevalence of hypertension was high, and it was the second most common underlying cause of death. The gold standard for the definition of cause of death, the autopsy, shows important results, which confirmed the relevance of hypertension as a public health problem.


RESUMEN Objetivo: Analizar la hipertensión y su relación con las causas de muerte identificadas por la autopsia. Método: Estudio transversal, que analizó a 356 participantes del Biobanco para Estudios en el Envejecimiento, con edad mayor a 50 años, autopsiados en el Servicio de Verificación de Defunciones entre los años 2004 y 2014. Una entrevista clínica fue realizada con el informante del fallecido. La hipertensión fue definida por el relato de la enfermedad y/o uso de medicación antihipertensiva por el informante del fallecido. Se llevaron a cabo análisis descriptivos y asociaciones bivariadas y multivariables. Resultados: La prevalencia de hipertensión arterial fue del 66,2% y fue la segunda causa básica de defunción (25,6%) identificada en la autopsia, precedida de aterosclerosis (37,8%). Las variables asociadas con la hipertensión fueron: género femenino (OR = 2,30 (1,34-3,90); tener a una pareja [OR = 0,55 (0,32-0,92)]; índice de masa corporal [OR = 1,14 (1,08-1,22)] e historia de diabetes [OR = 2,39 (1,34-4,27)]. Conclusión: La prevalencia de hipertensión fue elevada y representó la segunda causa básica de defunción más frecuente. El uso de la autopsia como regla de oro para definir la causa de la muerte confirmó la relevancia de la hipertensión como un problema de salud pública.


RESUMO Objetivo: Analisar a hipertensão e sua relação com as causas de morte identificadas pela autópsia. Método: Estudo transversal, que analisou 356 participantes do Biobanco para Estudos no Envelhecimento, com idade maior do que 50 anos, autopsiados no Serviço de Verificação de Óbitos entre os anos de 2004 a 2014. Uma entrevista clínica foi realizada com o informante do falecido. A hipertensão foi definida pelo relato da doença e/ou o uso de medicação anti-hipertensiva pelo informante do falecido. Foram realizadas análises descritivas e associações bivariadas e multivariáveis. Resultados: A prevalência de hipertensão arterial foi de 66,2% e foi a segunda causa básica de óbito (25,6%) identificada na autópsia, precedida de aterosclerose (37,8%). As variáveis associadas à hipertensão foram: gênero feminino (OR = 2,30 (1,34-3,90); ter um parceiro [OR = 0,55 (0,32-0,92)]; índice de massa corporal [OR = 1,14 (1,08-1,22)] e história de diabetes [OR = 2,39 (1,34-4,27)]. Conclusão: A prevalência de hipertensão foi elevada e representou a segunda causa básica de óbito mais frequente. O uso da autópsia como padrão-ouro para definir a causa da morte confirmou a relevância da hipertensão como um problema de saúde pública.


Asunto(s)
Humanos , Autopsia , Causas de Muerte , Hipertensión/mortalidad , Estudios Transversales
7.
Clin Infect Dis ; 67(6): 854-860, 2018 08 31.
Artículo en Inglés | MEDLINE | ID: mdl-29509833

RESUMEN

Background: Invasive Group B streptococcus (GBS) is a major cause of serious neonatal infection. Current strategies to reduce early-onset GBS disease have no impact on late-onset disease (LOD). Although GBS LOD is viewed as a sporadic event in the community, LOD arising within the neonatal intensive care unit (ICU) raises questions about mode of acquisition. Methods: Following a cluster of 4 GBS LOD cases, enhanced surveillance for all GBS LOD was undertaken over 2 years in the neonatal ICU supported by neonatal rectal screening. GBS isolates were serotyped and genome-sequenced. Results: Twelve late -onset invasive GBS episodes were identified (incidence 0.6/1000 live births). Genomic analysis revealed that 11/12 GBS isolates (92%) were linked to at least one other LOD isolate. Isolates from the first cluster were serotype V, resistant to macrolides and lincosamides, and sequencing confirmed isolates were indistinguishable, or distinguishable by only one SNP difference, from each other. Rectal carriage was rare. Prospective surveillance identified three further clusters of LOD due to serotypes Ia (3 cases), Ib (2 cases), and III (2 cases), that would not have been identified without surveillance and genome sequencing, leading to a re-evaluation of interventions required to prevent GBS LOD. Conclusion: Acquisition routes for LOD GBS in the neonatal ICU are poorly understood; cases may not necessarily be sporadic. Within this neonatal ICU, our data suggest that a single case of LOD GBS sepsis should be considered a potential nosocomial transmission event warranting prompt investigation, heightened infection prevention vigilance and action where required.


Asunto(s)
Unidades de Cuidado Intensivo Neonatal , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/epidemiología , Streptococcus agalactiae/genética , Bacteriemia/epidemiología , Análisis por Conglomerados , Genómica , Humanos , Incidencia , Recién Nacido , Tamizaje Neonatal , Filogenia , Estudios Prospectivos , Factores de Riesgo , Serogrupo , Streptococcus agalactiae/aislamiento & purificación , Reino Unido/epidemiología , Secuenciación Completa del Genoma
8.
Am J Infect Control ; 46(2): 238-240, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29031429

RESUMEN

We report an outbreak of invasive and noninvasive group A Streptococcus during April 2017 among people who inject drugs in southwest England. To date we have identified 14 cases linked to a specific town, all confirmed as group A Streptococcus emm94.0, a strain type not previously reported in the area. We have yet to identify a source for this ongoing outbreak. Actions described here may help reduce the burden of infection in vulnerable populations.


Asunto(s)
Brotes de Enfermedades , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/genética , Streptococcus pyogenes/aislamiento & purificación , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/epidemiología , Adulto , Recolección de Datos , Inglaterra/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
10.
J Antimicrob Chemother ; 72(10): 2704-2707, 2017 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-29091185

RESUMEN

Background: Like other streptococci, Streptococcus agalactiae typically has intrinsic low-level aminoglycoside resistance. High-level gentamicin resistance was seen in 2 of 1125 isolates collected in the BSAC Bacteraemia Surveillance Programme between 2001 and 2014. These organisms, both isolated in 2014, were characterized. Methods: Identifications were by latex agglutination, MICs by BSAC agar dilution and sequencing by Illumina methodology. Results: Gentamicin MICs were >1024 mg/L versus a species mode of 8 mg/L; both isolates also were unusually ciprofloxacin resistant with MICs of 64 mg/L versus a species mode of 1 mg/L. They were distinct by sequence, but both belonged to the ST19 clone, which occurs globally. Both had aac(6')-aph(2″), carried by different transposons, explaining their gentamicin resistance, and had gyrA[81:S-L];parC[79:S-Y], accounting for ciprofloxacin resistance. Conclusions: These are the first multiresistant S. agalactiae with the bifunctional AAC(6')-APH(2″) enzyme to be reported in the UK for >10 years. Despite belonging to the same clonal complex, the two isolates and their resistance transposons were distinct. Both retained full susceptibility to penicillin, but any penicillin/gentamicin synergy is likely to be lost.


Asunto(s)
Antibacterianos/farmacología , Bacteriemia/epidemiología , Farmacorresistencia Bacteriana/genética , Gentamicinas/farmacología , Análisis de Secuencia de ADN/métodos , Infecciones Estreptocócicas/epidemiología , Streptococcus agalactiae/genética , Bacteriemia/microbiología , Elementos Transponibles de ADN , Monitoreo Epidemiológico , Genoma Bacteriano , Genómica/métodos , Humanos , Pruebas de Sensibilidad Microbiana/métodos , Infecciones Estreptocócicas/microbiología , Streptococcus agalactiae/efectos de los fármacos , Streptococcus agalactiae/aislamiento & purificación
11.
Euro Surveill ; 22(19)2017 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-28537550

RESUMEN

Invasive group A streptococcal infection has a 15% case fatality rate and a risk of secondary transmission. This retrospective study used two national data sources from England; enhanced surveillance (2009) and a case management system (2011-2013) to identify clusters of severe group A streptococcal disease. Twenty-four household pairs were identified. The median onset interval between cases was 2 days (range 0-28) with simultaneous onset in eight pairs. The attack rate during the 30 days after first exposure to a primary case was 4,520 per 100,000 person-years at risk (95% confidence interval (CI): 2,900-6,730) a 1,940 (95% CI: 1,240-2,880) fold elevation over the background incidence. The theoretical number needed to treat to prevent one secondary case using antibiotic prophylaxis was 271 overall (95% CI: 194-454), 50 for mother-neonate pairs (95% CI: 27-393) and 82 for couples aged 75 years and over (95% CI: 46-417). While a dramatically increased risk of infection was noted in all household contacts, increased risk was greatest for mother-neonate pairs and couples aged 75 and over, suggesting targeted prophylaxis could be considered. Offering prophylaxis is challenging due to the short time interval between cases emphasising the importance of immediate notification and assessment of contacts.


Asunto(s)
Profilaxis Antibiótica/métodos , Vigilancia de la Población/métodos , Infecciones Estreptocócicas/prevención & control , Infecciones Estreptocócicas/transmisión , Streptococcus pyogenes/aislamiento & purificación , Adolescente , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Inglaterra/epidemiología , Composición Familiar , Femenino , Humanos , Incidencia , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/fisiología , Virulencia
12.
PeerJ ; 5: e3226, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28462035

RESUMEN

Streptococcus pyogenes group A Streptococcus (GAS) is the most common cause of bacterial throat infections, and can cause mild to severe skin and soft tissue infections, including impetigo, erysipelas, necrotizing fasciitis, as well as systemic and fatal infections including septicaemia and meningitis. Estimated annual incidence for invasive group A streptococcal infection (iGAS) in industrialised countries is approximately three per 100,000 per year. Typing is currently used in England and Wales to monitor bacterial strains of S. pyogenes causing invasive infections and those isolated from patients and healthcare/care workers in cluster and outbreak situations. Sequence analysis of the emm gene is the currently accepted gold standard methodology for GAS typing. A comprehensive database of emm types observed from superficial and invasive GAS strains from England and Wales informs outbreak control teams during investigations. Each year the Bacterial Reference Department, Public Health England (PHE) receives approximately 3,000 GAS isolates from England and Wales. In April 2014 the Bacterial Reference Department, PHE began genomic sequencing of referred S. pyogenes isolates and those pertaining to selected elderly/nursing care or maternity clusters from 2010 to inform future reference services and outbreak analysis (n = 3, 047). In line with the modernizing strategy of PHE, we developed a novel bioinformatics pipeline that can predict emmtypes using whole genome sequence (WGS) data. The efficiency of this method was measured by comparing the emmtype assigned by this method against the result from the current gold standard methodology; concordance to emmsubtype level was observed in 93.8% (2,852/3,040) of our cases, whereas in 2.4% (n = 72) of our cases concordance was observed to emm type level. The remaining 3.8% (n = 117) of our cases corresponded to novel types/subtypes, contamination, laboratory sample transcription errors or problems arising from high sequence similarity of the allele sequence or low mapping coverage. De novo assembly analysis was performed in the two latter groups (n = 72 + 117) and was able to diagnose the problem and where possible resolve the discordance (60/72 and 20/117, respectively). Overall, we have demonstrated that our WGS emm-typing pipeline is a reliable and robust system that can be implemented to determine emm type for the routine service.

13.
BMC Genomics ; 18(1): 224, 2017 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-28283023

RESUMEN

BACKGROUND: During a substantial elevation in scarlet fever (SF) notifications in 2014 a national genomic study was undertaken of Streptococcus pyogenes (Group A Streptococci, GAS) isolates from patients with SF with comparison to isolates from patients with invasive disease (iGAS) to test the hypotheses that the increase in SF was due to either the introduction of one or more new/emerging strains in the population in England or the transmission of a known genetic element through the population of GAS by horizontal gene transfer (HGT) resulting in infections with an increased likelihood of causing SF. Isolates were collected to provide geographical representation, for approximately 5% SF isolates from each region from 1st April 2014 to 18th June 2014. Contemporaneous iGAS isolates for which genomic data were available were included for comparison. Data were analysed in order to determine emm gene sequence type, phylogenetic lineage and genomic clade representation, the presence of known prophage elements and the presence of genes known to confer pathogenicity and resistance to antibiotics. RESULTS: 555 isolates were analysed, 303 from patients with SF and 252 from patients with iGAS. Isolates from patients with SF were of multiple distinct emm sequence types and phylogenetic lineages. Prior to data normalisation, emm3 was the predominant type (accounting for 42.9% of SF isolates, 130/303 95%CI 37.5-48.5; 14.7% higher than the percentage of emm3 isolates found in the iGAS isolates). Post-normalisation emm types, 4 and 12, were found to be over-represented in patients with SF versus iGAS (p < 0.001). A single gene, ssa, was over-represented in isolates from patients with SF. No single phage was found to be over represented in SF vs iGAS. However, a "meta-ssa" phage defined by the presence of :315.2, SPsP6, MGAS10750.3 or HK360ssa, was found to be over represented. The HKU360.vir phage was not detected yet the HKU360.ssa phage was present in 43/63 emm12 isolates but not found to be over-represented in isolates from patients with SF. CONCLUSIONS: There is no evidence that the increased number of SF cases was a strain-specific or known mobile element specific phenomenon, as the increase in SF cases was associated with multiple lineages of GAS.


Asunto(s)
Genoma Bacteriano , Genómica , Escarlatina/microbiología , Streptococcus pyogenes/genética , Antígenos Bacterianos/genética , Proteínas de la Membrana Bacteriana Externa/genética , Bacteriófagos/genética , Proteínas Portadoras/genética , Análisis por Conglomerados , Inglaterra/epidemiología , Transferencia de Gen Horizontal , Genómica/métodos , Humanos , Tipificación de Secuencias Multilocus , Filogenia , Vigilancia de la Población , Escarlatina/epidemiología , Streptococcus pyogenes/clasificación , Streptococcus pyogenes/virología
14.
Euro Surveill ; 22(3)2017 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-28128090

RESUMEN

We report an outbreak of invasive and non-invasive disease due to an unusual type of Streptococcus pyogenes (group A Streptococcus, emm66) among a vulnerable, largely homeless population in southern England and Wales, detected in September 2016. Twenty-seven confirmed cases were subsequently identified between 5 January and 29 December 2016; 20 injected drugs and six reported problematic alcohol use. To date, we have ruled out drug-related vehicles of infection and identified few common risk factors.


Asunto(s)
Brotes de Enfermedades , Personas sin Hogar/estadística & datos numéricos , Infecciones Estreptocócicas/epidemiología , Streptococcus pyogenes/aislamiento & purificación , Adulto , Distribución por Edad , Notificación de Enfermedades , Inglaterra/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Distribución por Sexo , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/prevención & control , Streptococcus pyogenes/clasificación , Streptococcus pyogenes/genética , Abuso de Sustancias por Vía Intravenosa/epidemiología , Poblaciones Vulnerables , Gales/epidemiología
16.
Parasite Epidemiol Control ; 2(3): 91-96, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29774286

RESUMEN

Mosquitoes can act as vectors of important diseases such as malaria, dengue, Zika virus, yellow fever, Chikungunya and Mayaro fever, in addition to filariasis. The use of insecticides, larvicides, bed nets and repellents, besides the use of drugs as chemoprevention and the treatment of the sick are currently the pillars of the control of these vectors. We studied the biological control against of Anopheles darlingi, Aedes aegypti and Culex quinquefasciatus larvae using shrimps of the species M. pantanalense, M. amazonicum, M. brasiliense and M. jelskii. Larvae of mosquitoes were collected from the breeding environment and placed in a 500 and 1000 l tank containing 60 shrimps/m2. The predatory activity was evaluated for 30 days and, in all groups it was observed that 100% of the larvae were consumed in few minutes. In the environment, these same species of crustaceans were released in water bodies with the presence of larvae of these insects. In just 72 h there was a marked reduction of the larvae in the release sites of shrimps. Similarly, there was a reduction in the number of adult mosquitoes caught near the breeding sites, allowing to infer that, in places where the crustaceans were released, the predatory activity on the larvae of mosquitoes was sufficient to reduce the number of adult mosquitoes p ≤ 0,05. This is the first description of the predatory activity of M. pantanalense, M. amazonicum, M. brasiliense and M. jelskii on An. darlingi, A. aegypti and C. quinquefasciatus larvae, constituting an important tool of biological control of these parasites-vectors.

17.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 54(4): 416-419, 2017. ilus
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-912054

RESUMEN

In Brazil dipters of the Lutzomyia genus are the main vectors of leishmaniasis for humans and animals. However, other hematophagous insects such as ticks, fleas, and horse flies may also be considered potential vectors of this protozoon. This paper, regarding an endemic area for visceral leishmaniasis, is the the first description of the Leishmania spp. presence in Aedes aegypti mosquitoes. Two A. aegypti mosquitoes were captured: one of them was feeding on a polysymptomatic dog with leishmaniasis, confirmed by parasitic demonstration and positive PCR for Leishmania spp., and the other was collected in the environment where the dog was isolated. The mosquito engorged with dog's blood was crushed between two microscopic slides and the other one was processed by the polymerase chain reaction assay (PCR) searching for the presence of Leishmania spp. DNA. Amastigote forms of Leishmania sp, were observed in the smear prepared from one mosquito by microscopic examination, as well as other protozoa's flagellated forms. In the other insect it was observed Leishmania DNA amplification. This observation reinforces the role of dogs as sources of infection of Leishmania spp. even to other potential vector species.(AU)


No Brasil, os dípteros do gênero Lutzomyia são os principais vetores da leishmaniose para humanos e animais. No entanto, tem sido constatado que outras espécies de invertebrados hematófagos, como carrapatos, pulgas e mutucas, também podem ser vetores desse protozoário. Este trabalho, realizado em uma área endêmica de leishmaniose visceral, é a primeira descrição da presença de Leishmania spp. em mosquitos da espécie A. aegypti. Dois mosquitos A. aegypti foram capturados no local onde estava isolado um cão polissintomático acometido por leishmaniose visceral, confirmada pela demonstração do parasita em biópsias de órgãos e por resultado positivo na prova de PCR para Leishmania spp. Um dos mosquitos estava sugando o sangue do cão e o outro estava livre no ambiente. O mosquito ingurgitado com o sangue do animal foi esmagado entre duas lâminas de microscopia e o outro foi processado por meio da reação em cadeia pela polimerase (PCR) aplicada à pesquisa do ADN de Leishmania spp. Ao exame microscópico do esfregaço preparado com o mosquito que estava parasitando o cão foram observadas formas amastigotas de Leishmania spp., bem como formas flageladas de outra espécie de protozoário. No outro inseto foi detectada amplificação de ADN do gênero Leishmania. Esta constatação reforça o papel dos cães como fontes de infecção de Leishmania spp. até mesmo para outras espécies de vetores potenciais.(AU)


Asunto(s)
Animales , Perros , Aedes/patogenicidad , Leishmaniasis/etiología , Leishmaniasis/veterinaria , Leishmania/aislamiento & purificación , Vectores de Enfermedades , Flagelos/parasitología
18.
Saúde Soc ; 25(2): 408-421,
Artículo en Portugués | LILACS | ID: lil-787843

RESUMEN

A cultura condiciona as representações de velhice e de gênero com reflexos nas percepções sobre a saúde, a doença e o cuidado. A interface entre esses fenômenos é objeto deste estudo, fundamentado na perspectiva da antropologia médica, que pretende investigar como os homens idosos da comunidade expressam e percebem a relação entre saúde, doença, masculinidade e envelhecimento, e como esses construtos se relacionam com os subsistemas de cuidado informal e profissional. Foram entrevistados 27 homens com 60 anos ou mais, residentes em Bambuí (MG) e assistidos pela Estratégia Saúde da Família, acerca de suas atividades cotidianas, sua saúde e suas formas de cuidado. O modelo de signos, significados e ações, utilizado na coleta e análise dos dados, permitiu reconhecer as maneiras típicas de pensar e agir de homens idosos em relação ao processo saúde-doença-cuidado, bem como suas interações e contradições junto aos setores profissional e informal do sistema de cuidado em saúde. A produção material e simbólica dos entrevistados demonstra a identidade masculina ligada ao conceito de saúde, o qual se vincula às relações sociais, que fundamentam o cuidado informal à saúde. Contrapondo-se a essa percepção está a visão de envelhecimento inexoravelmente relacionada à doença, em que se ancora o sistema profissional de cuidado. Assim, homens idosos restringem a procura por cuidados em saúde em parte pela própria construção sociocultural da masculinidade que renega a fragilidade, mas também porque as ações e os profissionais de saúde desconsideram as especificidades de gênero e o valor dado pelos homens idosos à independência funcional.


Culture determines representations of old age and gender that influence the perceptions of health, illness and care. The interface between these phenomena is the object of this study, based on the perspective of medical anthropology, which aims to investigate how older men from community express and perceive the relationship between health, disease, aging and masculinity, and how these social constructs relate to subsystems informal and professional care. We interviewed 27 men aged 60 or older, living in Bambuí (MG) and assisted by the Family Health Strategy, about their daily activities, their health and their forms of healthcare. The model of signs, meanings and actions, used in the collection and analysis of data, allowed recognizing the typical ways of thinking and acting of older men in relation to the health-illness-care process, as well as their interactions and contradictions regarding to the professional and informal sectors of healthcare system. The material and symbolic production of the respondents shows that in general the male identity is linked to the concept of health, which is tied to the social relations that underlie the informal healthcare. Opposed to this perception is the aging view inexorably related to sickness, in which the professional care system is anchored. Thus, older men restrict their demand for healthcare in part because their own socio-cultural construction of masculinity denies the frailty, but also this is due to the health actions and health professionals that ignore the specificities of gender and the value of the functional independence to older men.


Asunto(s)
Humanos , Masculino , Anciano , Anciano , Envejecimiento , Prestación de Atención de Salud , Sistemas de Salud , Proceso Salud-Enfermedad , Masculinidad , Antropología Médica , Estrategia de Salud Familiar , Autonomía Personal , Caracteres Sexuales
19.
Emerg Infect Dis ; 22(6): 973-80, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27192043

RESUMEN

Single-strain outbreaks of Streptococcus pyogenes infections are common and often go undetected. In 2013, two clusters of invasive group A Streptococcus (iGAS) infection were identified in independent but closely located care homes in Oxfordshire, United Kingdom. Investigation included visits to each home, chart review, staff survey, microbiologic sampling, and genome sequencing. S. pyogenes emm type 1.0, the most common circulating type nationally, was identified from all cases yielding GAS isolates. A tailored whole-genome reference population comprising epidemiologically relevant contemporaneous isolates and published isolates was assembled. Data were analyzed independently using whole-genome multilocus sequencing and single-nucleotide polymorphism analyses. Six isolates from staff and residents of the homes formed a single cluster that was separated from the reference population by both analytical approaches. No further cases occurred after mass chemoprophylaxis and enhanced infection control. Our findings demonstrate the ability of 2 independent analytical approaches to enable robust conclusions from nonstandardized whole-genome analysis to support public health practice.


Asunto(s)
Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/genética , Alelos , Biología Computacional/métodos , Farmacorresistencia Bacteriana , Genoma Bacteriano , Genómica/métodos , Instituciones de Salud , Humanos , Filogenia , Polimorfismo de Nucleótido Simple , Infecciones Estreptocócicas/prevención & control , Infecciones Estreptocócicas/transmisión , Streptococcus pyogenes/efectos de los fármacos , Streptococcus pyogenes/patogenicidad , Reino Unido/epidemiología , Virulencia/genética , Secuenciación Completa del Genoma
20.
Disabil Rehabil ; 38(22): 2229-34, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-26800790

RESUMEN

PURPOSE: To verify the applicability, reproducibility and validity of the SCIM III patients with non-traumatic spinal cord injury. METHOD: The cross-sectional study included 30 patients (66% females; 41.5 ± 14.7 yo) with non-traumatic spinal cord injury of any etiology. Subjects were subjected by computerized gait analysis and answered the Brazilian versions of SCIM III (0-100 points) and FIM™ (18-126 points) by two raters (A and B) at the same day and 1 week later (A). RESULTS: The intraclass correlation coefficient for the use of SCIM III indicated appropriated intra- and inter-evaluator reproducibility (ICC = 0.9). Correlation between the SCIM III and the motor FIM™ was appropriate (r = 0.6; p = 0.0). SCIM III subscales and FIM™ domains correlated strongly for self-care (r = 0.8; p ≤ 0.001), moderately for transfers (r = 0.6; p = 0.0005) and locomotion (r = 0.6; p = 0.0006). SCIM III mobility subscale positively correlated with the cadence (r = 0.8; p ≤ 0.01), gait speed (r = 0.7; p ≤ 0.01) and step length (r = 0.6; p ≤ 0.01). CONCLUSIONS: SCIM III is a reproducible functional assessment instrument and capable of evaluating the level of independence of the individual with non-traumatic spinal cord injury. The SCIM III is more sensitive than the MIF™ for non-traumatic spastic paraplegic patients with higher levels of independence, particularly if they can walk independently. Linear gait parameters correlated with its mobility subscale. Implications for Rehabilitation Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions. There are not many studies focused on patients with non-traumatic spinal cord lesion. Disability varies in severity, but frequently contributes to limitations in the activities of daily living (ADL) and participation. We do not find in the literature studies that assess the functionality of these individuals as comprehensive as ours.


Asunto(s)
Actividades Cotidianas , Evaluación de la Discapacidad , Paraplejía/diagnóstico , Traumatismos de la Médula Espinal/rehabilitación , Adulto , Brasil , Estudios Transversales , Femenino , Marcha , Humanos , Masculino , Persona de Mediana Edad , Modalidades de Fisioterapia , Reproducibilidad de los Resultados , Autocuidado/métodos , Índice de Severidad de la Enfermedad
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